Provider Demographics
NPI:1407207103
Name:UNION DENTAL CARE, JEFFREY J. HILDEBRANDT, DDS, INC.
Entity Type:Organization
Organization Name:UNION DENTAL CARE, JEFFREY J. HILDEBRANDT, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HILDEBRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-243-8888
Mailing Address - Street 1:17535 ROSBOUGH BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-8362
Mailing Address - Country:US
Mailing Address - Phone:440-243-8888
Mailing Address - Fax:
Practice Address - Street 1:17535 ROSBOUGH BLVD STE 203
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-8362
Practice Address - Country:US
Practice Address - Phone:440-243-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental